Wishing I wasn't an RN when it comes to sick family member.

[Avery205]

I love being a nurse. I went back to school at age 33 to become an RN. I've had my share of helping to save lives as well as being there in the final moments of life for patients who are on hospice. I've seen many patients who have or will have such a poor quality of life that it seems cruel to keep them going by any means necessary while families sit there like an audience for a performance and watch their family member wither away as I do my job to keep them dry, turned, bathed, fed (if possible), and comfortable. As a nurse, I see things from a different persective than family members, yet try to understand that this is their family member whom they don't want to live without. Often, I wish that hospice or at least a change is code status was more of a norm than a fear or taboo subject for patients and family members. I get tired of seeing so much suffering by patients while family members sit there with a blind eye turned to their family member's quality of life.

My dilemma right now is that I have a family member in this situation. I am wishing that I could be that family member to turn a blind eye to what he is going through and hope for the best like everyone else. The thing is that I can't. I am an RN and I know what his day is like and his quality of life and I pray for him like everyone else in the family, but my prayer is not that he gets better and comes home, it's that he dies peacefully. But that is not happening. He has been in the hospital since the end of July when he collapsed. The paramedics did CPR and defibrillated him twice and intubated him on the way to the hospital and it has been a series of ups and downs from there. On his best day since that time, he was able to eat some soup and walk 10 feet with a walker. He already had COPD and heart disease among other things, but now also has an AICD, CHF and renal failure in addition to his multiple infections over the last few months (VRE, cdiff, etc.) He was intubated earlier in the week and remains on a vent with the possibility of now also needing dialysis.

This family member is my step father in law. He has a large family and step family with a lot of family dynamics. He is the typical patient that no one wants to take care of because of the entire picture. When I found out yesterday that they may start him on dialysis I just cried and cried for him. I don't want to lose him either, but I don't want him to suffer like this. He is a very proud, strong man and I think he would would want to live like this. I have a difficult time talking with my husband about it. I just try to listen, because when I give my opinion or advice I just seem cold and insensitive because I can't turn off the RN in me.

Any advice as how to handle my feelings on this yet be sensitive to the family would be greatly appreciated. Thank you for letting me vent.

[ballerinagirl]

sounds like a terrible situation.

However, don't forget that when people want to "go", they make it very clear. Have you considered that maybe he wants to hang on as long as he can (for what reason, we may not know)? If the patient isn't ready, it wouldn't be right for us to tell him it's the best thing because only the patient truly knows.

Yes, I understand the quality of life arguments (and sometimes they are valid), but we also have to remember that even if we think we would not want to live like that, we have to be open to the possibility that someone might want to take that over dying. Maybe they're scared to let go, maybe not -- who really knows.

I don't envy your situation -- I wish there were an easy solution, but we must let things happen on their own time and sometimes, it's not up to us to decide. All you can really do is be the source of information

I am truly sorry for your dilemma.

[pbirdy]

I'm sorry to hear what you are going thru. I don't know what to say that can help you. I was a cardiac nurse working on a telemetry unit when I was called to say my dad had a heart attack. He lives in another state and when I went to see him, he really only had mild chest pain and was admitted. Of course he went thru all the tests but when I was looking thru all the charts, I could see that he would develop other problems along the way.

The entire family would not listen to me. To make it short........in a few months he eventually had heart problems resulting in a pace maker.

I have come to the conclusion that just because you are a nurse, your family members don't regard you with the respect that you deserve. I don't believe that they see you as a professional. My advice is to just be supportive and be very brief in what you feel needs to be done. Your going to be right because of your experiences but your family will never understand what you go thru in your everyday life as a nurse. I think that they need to hear it from someone eles. In their mind, it gives them more hope. Don't take it personally.

[Ayvah, RN]

I would suggest that you be direct and blunt with your husband, as this is his father in law. I do agree that if your step father in law made his wishes clear, and he has no quality of life, then starting on dialysis seems a questionable way to go. I know its not something I would want if I was in his state, and the majority of us nurses have seen some pretty rough family situations where the patient's wishes are not honored and the passing of a loved one is made more complicated, painful, and prolonged.

I wish you the best. You have to balance your step father in law's seeming readiness to pass, and the rest of your husband's family's acceptance of that. You don't want the family hurt by thinking they did not do all they could to help him, but you want the passing of your step father in law to be as respectful and comfortable as possible. Not an easy task and I wish you the best. Yet another reminder to all of us that these hard conversations need to take place, and documents need to be in order.

[elizabeth8503RN, MSN, EMT-B, NP]

((((hugs))))

It is very difficult to know whats going on with a family member. I am currently going through that with my grandmother. Numerous health issues (CHF, renal failure, pneumonia, blood problems, recovering from HIT, diabetes, history of strokes and one major MI), she was just released from the hospital today after being in the hospital for 8+weeks. She refused (thank God) dialysis, and is staying in a nursing home for now. I fear she won't make it for much longer, but you can't tell that to my gpa.

My only advice is to love them as long and as hard as you can, and if and when it is their time to pass, be there for the family. You can't fix them, no matter how hard you try (believe me I have tried). So all you can do is hang on for the ride and hope that when its all said and done, the healing process will begin.

Know that when he passes, he will be in a better place, and will not be hurting anymore.

Again...((((hugs))))

[Avery205]

I want to thank all of you who posted responses to my emotional dilemma. Thanks for all your advice and all your words of support for me and my family. I just wanted to update all of you and let you know that my father in law did pass away early this morning. His blood pressure dropped and would not respond to any of the meds they tried to bring it back up. His heart finally gave out. He was still on the vent and the ICD did not fire, so it was truely his time to go. My mother in law and the rest of the family were spared the decision to stop treatment and he did pass peacefully with his wife and most of his 9 children and their spouses at his side. I believe everything happens for a reason. He fought for his life as long as he could. His family fought with him as best they knew how. He is now at peace and that's all that really matters.

Again, thank you all.

[MedSurgeMess]

So very sorry for your loss. As you stated, he is in a much better place, with no pain. God bless you and all of his family.....

[mamamerlee, LPN]

So sorry for your loss; take care of your husband, and grieve with your family. Be kind to yourself.

[JBudd, MSN]

:cry:Sending hugs and prayers to you, {{{{{{{{Medsurg}}}}}}}

:redpinkhe

[freefalr]

oh avery, i'm so sorry for the loss of your father-in-law. his suffering is over and he is now at peace. prayers of comfort to you, your husband, and your family ((avery))

[elizabeth8503RN, MSN, EMT-B, NP]

Sorry for your loss. {{{{{hugs}}}}